Healthcare Provider Details

I. General information

NPI: 1427110527
Provider Name (Legal Business Name): WOOSTER ENT ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 CLEVELAND RD
WOOSTER OH
44691-2203
US

IV. Provider business mailing address

1749 CLEVELAND RD
WOOSTER OH
44691-2203
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-9699
  • Fax: 330-264-7999
Mailing address:
  • Phone: 330-264-9699
  • Fax: 330-264-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCES M BEAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 330-264-9699